기계적 삭제방법을 이용한 치면열구전색제의 열구침투도 및 미세누출
The fissure penetration and microleakage of pit and fissure sealantwith mechanical preparation
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초록
교합면 치아우식 예방을 위한 치면열구전색제 도포시 열구내 유기물, 치태, 법랑질 잔사 등을 제거하여 전색제의 유지율을 증가시키고자 기계적 삭제 방법이 소개되었다. 기계적 삭제방법을 사용할 경우 산부식 방법만을 사용하였을 때와 비교하여 치면열구전색제의 열구 침투도 및 미세누출정도의 차이는 임상적인 측면에서 중요하다. 따라서 이 연구에서는 기계적 삭제 방법(소와열구 삭제 후 산부식)과 산부식 방법을 시행한 후, 각각 unfilled sealant와 filled sealant를 처치하고 이들 치면열구전색제의 열구 침투도와 미세누출 정도를 측정하였다. 교정치료를 목적으로 발거된 사람의 소구치 60개를 실험재료로 사용하였으며 그중 30개는 산부식 처리하고 나머지 30개는 소와열구의 기계적 삭제와 산부식 처리를 시행한 후 각각의 방법에서 15개는 unfilled sealant로 나머지 15개는 filled sealant로 수복하였다. Thermocycling(5℃와 55℃ 1200회)을 시행하고 5% methylene blue 용액에 24시간 보관하였다가 각각의 치아를 근심소와와 원심소와에서 협설 방향으로 절단하여 120개의 절단면을 얻었다. 각 절단면을 Measurescope으로 관찰한 결과, 기계적 삭제 방법은 산부식만을 시행한 경우에 비하여 unfilled sealant와 filled sealant 모두 열구 침투도를 증가시켰다(P < 0.05). 기계적 삭제 방법을 사용한 경우 산부식 방법만을 사용하고 unfilled sealant로 수복한 경우에 비하여 미세누출이 적었고(P < 0.05), 산부식 방법만을 사용하고 filled sealant로 수복한 경우와는 미세누출에 차이가 없었다. Unfilled sealant와 filled sealant는 기계적 삭제 방법을 사용한 경우와 산부식 방법만을 사용한 경우 모두 열구 침투도나 미세누출에 있어서 유의한 차이가 없었다. 이상의 결과로 보아 치면열구전색제 도포 시 열구 침투도가 우수하고 미세누출이 적은 기계적 삭제 방법과 물리적 성질이 우수한 filled sealant의 사용이 바람직하다고 생각된다. 그러나 미세누출에 있어 교합력을 고려한 실험이나 장기간의 임상실험이 필요할 것이다.
Abstract
Mechanical preparation has been introduced to provide the sealant retention. The objective of this study was to compare the fissure penetration and the microleakage of pit and fissure sealant using mechanical preparation(mechanical preparation + acid etching) and acid etching only. An additional objective of this study was to compare the fissure penetration and the microleakage of unfilled and filled sealant in both methods. Sixty human premolars extracted for orthodontic purpose were selected. Thirty teeth were acid etched alone and remaining thirty teeth were prepared with a ¼ round bur and then acid etched. One-half of teeth in each surface treatment method were sealed with unfilled sealant and the other half were sealed with filled sealant. All of the teeth were thermocycled for 1200 cycles at 5℃ and 55℃ and immersed in 5% methylene blue for 24 hours. Each tooth was sectioned bucco-lingually at mesial pit and distal pit and examined under a Measurescope. In the case of mechanical preparation, fissure penetration of sealant was significantly increased compared with the case of acid etching only(P < 0.05). The filled and unfilled sealant using mechanical preparation showed significantly decreased microleakage when compared with the unfilled sealant using acid etching only(P < 0.05). No differences were found in fissure penetration and microleakage between unfilled and filled sealant in both methods. Taken together, the results of this study suggest that mechanical preparation and filled sealant are recommended when placing pit and fissure sealant. However, further clinical studies should be performed in regard to microleakage.
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